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糖尿病黄斑水肿主要由于血管通透性的增加、血-视网膜屏障破坏、视网膜内或视网膜下液体的异常积聚,导致患者视力损害。以往主要以激光光凝治疗,但其疗效不确切。研究表明玻璃体注射糖皮质激素可有效治疗各种原因引起的黄斑水肿,糖皮质激素因易进入细胞内与胞浆广泛的激素受体结合,形成各种蛋白质,发挥生物效应,进而稳定血-视网膜屏障。但需注意视网膜毒性效应,引起眼压升高以及白内障发生的可能性。综述了糖皮质激素治疗黄斑水肿的作用机制及其在糖尿病黄斑水肿治疗中的研究进展。
Diabetic macular edema is mainly due to an increase in vascular permeability, blood-retinal barrier destruction, and abnormal accumulation of intra- or subretinal fluids that result in visual impairment in patients. In the past mainly to laser photocoagulation treatment, but its efficacy is not exact. Studies have shown that vitreous injection of glucocorticoid can effectively treat macular edema caused by a variety of reasons, glucocorticoids easily enter the cell with a wide range of hormone receptors in the cytoplasm to form a variety of proteins, play a biological effect, and thus stabilize the blood - the retina barrier. However, attention should be paid to retinal toxicity, causing increased intraocular pressure and the possibility of cataracts. The mechanism of glucocorticoid treatment of macular edema and its research progress in the treatment of diabetic macular edema were reviewed.